Pregnancy and Childbirth

Pregnancy and Childbirth

While pregnancy is a universal experience, the safety of pregnant individuals varies significantly depending on their location and the quality of medical care available to them.

The World Health Organization defines maternal sepsis as a severe infection in pregnancy, post-abortion, childbirth, or the postpartum phase. Sepsis, initially referred to as blood poisoning, is a life-threatening condition where the body has an extreme reaction to infection. Similar to heart attacks or strokes, sepsis is an emergency condition that demands immediate diagnosis and treatment. It actually causes more deaths and disabilities annually compared to lung cancer, breast cancer, and stroke combined.

Sepsis and septic shock can be triggered by infections in any part of the body, such as influenza, pneumonia, or urinary tract infections. Globally, one-third of individuals who develop sepsis do not survive. Those who do often endure long-term effects, including chronic pain and fatigue, post-traumatic stress disorder (PTSD), organ dysfunction, and sometimes amputations.

How Sepsis Occurs During Pregnancy and After Childbirth

Sepsis can develop from infections directly linked to pregnancy or childbirth, as well as infections that are unrelated, like urinary tract infection (UTI) or pneumonia. The latest analysis of childbirth hospitalizations and postpartum readmissions found that about 23% of in-hospital fatalities were connected to sepsis. Bacterial infections like E. coli are commonly responsible for triggering maternal sepsis, and pregnant women are also at a heightened risk of COVID-19 complications.

In general, sepsis can result from a variety of complications, including:

  • Miscarriages or induced abortions: Infections are a risk after any miscarriage or abortion, particularly non-sterile abortions performed outside healthcare settings. Individuals who have had an abortion should monitor for signs of infection, including increasing or persistent pain, discolored or foul-smelling discharge, fever, abdominal tenderness, exhaustion, and feeling generally unwell.
  • Cesarean sections: Since cesarean sections are major surgeries, they carry the risk of post-surgical infections, which can lead to sepsis.
  • Prolonged or obstructed labor: When labor lasts an unusually long time or stops progressing, it increases the likelihood of infection.
  • Ruptured membranes: If the water breaks but labor doesn’t progress in a timely manner, the risk of infection rises the longer the period between rupture and delivery.
  • Infection after vaginal delivery: While rare in developed countries with access to healthcare, infections after vaginal delivery are more common in regions with limited healthcare resources.
  • Mastitis: An infection in the breasts can lead to sepsis if not properly managed.
  • Viral or bacterial diseases: Any infection that increases the general population’s risk of sepsis can also do so in pregnancy.

Risk Factors

All pregnant mothers and females who have experienced a miscarriage or abortion or have recently given birth are at risk of maternal or postpartum sepsis. Nevertheless, some women face a higher risk due to various factors.

Risk factors for developing maternal sepsis include:

  • Nulliparity (first-time pregnancy)
  • Lack of health insurance or public health coverage
  • Cesarean section (C-section).
  • Use of assisted reproductive technologies.
  • Multiple births (twins, triplets, etc.)

Additionally, o may be susceptible to sepsis:

The following individuals may be at higher risk of contracting an infection that can result in sepsis:

  • Those who have diabetes
  • Those who get pregnant with the aid of intrusive procedures
  • Those subjected to intrusive testing when pregnant

Detecting Sepsis during Pregnancy and After Childbirth

Sepsis diagnosis in pregnancy or the postpartum period can be difficult due to the many physiological changes the body undergoes during these times. For instance, pregnancy and childbirth cause a rapid heart rate, blood pressure changes, and increased breathing rate. These symptoms, while typical in pregnancy, can also signal an infection, making it harder for healthcare providers to immediately recognize sepsis.

Additionally, common postpartum symptoms such as chills, heavy sweating, pain, dizziness, or lightheadedness can overlap with signs of sepsis. These are often seen as normal responses to childbirth, which may delay suspicion of sepsis.

Some infections can also be misinterpreted during pregnancy. For instance, urinary tract infections (UTIs) often cause frequent urination, a symptom that can occur due to pregnancy itself. As a result, individuals may attribute this to their pregnancy rather than suspecting an infection, which can delay the diagnosis of sepsis.

Vaccination during Pregnancy

CDC advises women to be current on their vaccinations before conceiving. It’s important to discuss your immunity to common childhood diseases with your GP and whether you require any boosters. Additionally, pregnant mothers are encouraged to receive the seasonal flu vaccine. If you plan to travel, you may also need specific vaccines based on your destination.

 

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